Browsing by Author "Kalkan, G"

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    Epidemiological characteristics of different types of adult acne in Turkey: a prospective, controlled, multicenter study
    Kutlu, Ö; Karadag, AS; Demirseren, DD; Iyidal, AY; Tosun, M; Kalkan, G; Polat, M; Kemeriz, F; Türkoglu, Z; Erdogan, HK; Aktürk, AS; Alyamaç, G; Özden, HK; Kiliç, S; Kilinç, F; Akbulut, TO; Ermertcan, AT; Saricaoglu, H; Cemil, BC; Kayiran, MA; Aksoy, H; Alpsoy, E
    Introduction: Acne occurring in adults over the age of 25 years is known as acne tarda or adult acne. Three types of adult acne are recognized: persistent, late-onset, and recurrent acne. Most studies do not compare the characteristics between the three vari-ants. In addition, little is known about adult acne in males. This study describes the epidemiological factors of adult acne and investigates certain triggering factors by sex and different types of adult acne. Methods: A multicenter, prospective, descriptive study was conducted. Patients with adult acne and an acne-free control group were compared regarding medical history, family history, smoking and drinking habits, and dietary factors. In addition, triggering and prognostic factors were investigated by sex and three different types of acne: persistent, late-onset, and recurrent acne. Results: The participants included 944 (88.56%) female and 122 (11.44%) male patients with adult acne, and 709 (73.85%) female and 251 (26.15%) male control patients. The consumption of crackers, chocolate, and pasta was significantly more common in the acne group than in the control group (p = 0.017, 0.002, and 0.040, respectively). Male patients with adult acne had a significantly longer disease duration than female patients with adult acne (p = 0.024). The most common type of acne was recurrent acne, followed by persistent and late-onset acne. Among patients with persistent acne, 14.5% had polycystic ovary syndrome (PCOS), whereas 12.2% of patients with recurrent acne and 11.1% of patients with late-onset acne had PCOS. Severe acne was more com-mon in the persistent acne type (28.13%). The cheek (59.90%) was the most common involvement area, and stress (55.23%) was the most common triggering factor regardless of sex. Conclusions: Although adult female and male patents with adult acne share similar triggering factors, the involvement areas can differ, which may indicate the additional hormonal etiology of female adult acne. Further epidemiological studies on adult acne in both sexes may illuminate the pathogenesis of the disease, thus making possible the development of new treatment strategies.
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    Analysis of factors influencing target PASI responses and side effects of methotrexate monotherapy in plaque psoriasis: a multicenter study of 1521 patients
    Erduran, F; Emre, S; Hayran, Y; Adisen, E; Polat, AK; Üstüner, P; Öztürkcan, S; Öztürk, P; Ermertcan, AT; Selçuk, LB; Aksu, EK; Akbas, A; Kalkan, G; Demirseren, D; Kartal, SP; Topkarci, Z; Kilic, A; Yaldiz, M; Aytekin, S; Hizli, P; Gharehdaghi, S; Borlu, M; Isik, L; Botsali, BR; Solak, EO; Albayrak, H; Gönülal, M; Balci, DD; Polat, M; Daye, M; Ataseven, A; Yildiz, S; Özer, I; Zorlu, O; Dogan, S; Erdemir, VA; Dikicier, BS
    Methotrexate (MTX) is commonly used as first-line systemic treatment agent in psoriasis. We aimed to evaluate the clinical characteristics and treatment responses of patients with psoriasis undergoing MTX monotherapy. Data from adult patients with plaque psoriasis who received MTX monotherapy for at least 3 months between April 2012 and April 2022 were retrospectively evaluated in 19 tertiary care centers. Our study included 722 female and 799 male patients, a total of 1521 participants. The average age of the patients was 44.3 +/- 15.5 years. Mode of treatment was oral in 20.4% of patients while in 79.4% it was subcutaneous. The median treatment duration was 8 months (IQR = 5-15). The median weekly dose was 15 mg (IQR = 11-15). 1448 (95.2%) patients were taking folic acid supplementation. At week 12, 16.3% of the patients achieved PASI (Psoriasis Area and Severity Index) 90 response while at week 24, 37.3% achieved it. Logistic regression analysis for week 12 identified the following independent factors affecting PASI 90 achievement positively: median weekly MTX dose <= 15 mg (P = 0.011), subcutaneous administration (P = 0.005), no prior systemic treatment (< 0.001) and folic acid use (0.021). In logistic regression analysis for week 24; median weekly MTX dose <= 15 mg (P = 0.001), baseline PASI >= 10 (P < 0.001), no prior systemic treatment (P < 0.004), folic acid use (P = 0.001) and absence of comorbidities (P = 0.009) were determined as independent factors affecting the achievement of PASI 90. Adverse effects were observed in 38.8% of the patients, with nausea/vomiting (23.9%) and transaminase elevation (13%) being the most common. The most common reasons for interruptions (15.3%) and discontinuations (27.1%) of the treatment were patient related individual factors. The use of MTX as the first systemic treatment agent, at doses <= 15 mg/week and concurrent folic acid application are positive predictive factors for achieving the target PASI response both at weeks 12 and 24. In our study, which is one of the most comprehensive studies on MTX treatment in psoriasis, we observed that MTX is an effective and safe treatment option.
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    The natural history study of hidradenitis suppurativa: A large-scale multicenter study in turkey
    Alpsoy, E; Karaman, BF; Demirseren, D; Cinar, L; Kacar, N; Ermertcan, AT; Baskan, EB; Ucmak, D; Mammadli, K; Kilinç, F; Yazici, S; Temiz, SA; Akbulut, TÖ; Ataseven, A; Aktürk, AS; Saricaoglu, H; Türkmen, M; Gülbasaran, F; Engin, B; Ozden, HK; Durmaz, K; Ozden, MG; Ozdemir, H; Cemil, BC; Solak, SS; Yavuz, IH; Yavuz, GO; Guven, M; Ekinci, AP; Atici, T; Balci, DD; Oztürk, A; Altunay, IK; Ozkur, E; Ugurer, E; Karadag, AS; Kalkan, G; Erdogan, B; Yayli, S; Selcuk, LB; Donmez, L; Bilgic, A
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    Sociodemographic, clinical, laboratory, treatment and prognostic characteristics of 156 generalized pustular psoriasis patients in Turkey: a multicentre case series
    Polat, AK; Alpsoy, E; Kalkan, G; Aytekin, S; Uçmak, D; Güner, RY; Topkarci, Z; Yilmaz, O; Emre, S; Borlu, M; Türkoglu, Z; Akbulut, TÖ; Yavuz, GÖ; Erdogan, HK; Adisen, E; Kaya, AS; Topal, IO; Yazici, S; Yilmaz, E; Aksu, AEK; Kartal, SP; Deveci, BN; Solak, EÖ; Karadag, AS; Solak, SS; Altunay, IK; Ermertcan, AT; Kurt, BÖ; Kaçar, NG; Ataseven, A
    Background Generalized pustular psoriasis (GPP) is a rare and severe inflammatory disease characterized by widespread and superficial sterile pustules on an erythematous background. Objectives This multicentre study aimed to determine the clinical profile and course in a large cohort of patients with GPP. Methods One hundred and fifty-six GPP patients (mean age, 44.2 +/- 18.7 years) who met the diagnostic criteria of the European Consensus Report of GPP were included in the study. Sociodemographic characteristics, quality of life, triggering factors of the disease, clinical, laboratory, treatment and prognostic features were evaluated. Results 61.5% of the patients were female. The rate of working at or below the minimum wage (<=$332.5/month) was 44.9%. Drugs (36.5%) were the most common trigger. While hypocalcaemia (35.7%) was the most important cause of GPP during pregnancy, systemic steroid withdrawal (20%) was the most frequently reported trigger for infantile/juvenile and mixed-type GPP (15%) (P < 0.05). Acute GPP (53.8%) was the most common clinic. Nails were affected in 43.6% of patients, and subungual yellow spots (28.2%) were the most common change. In annular GPP, fever (P < 0.001) and relapse frequency (P = 0.006) were lower than other subtypes, and the number of hospitalizations (P = 0.002) was lower than acute GPP. GPP appeared at a later age in those with a history of psoriasis (P = 0.045). DLQI score (P = 0.049) and joint involvement (P = 0.016) were also higher in this group. Infantile/juvenile GPP was observed in 16.02% of all patients, and arthritis was lower in this group (24.4 vs. 16%). GPP of pregnancy had the worst prognosis due to abortion observed in three patients. Conclusions Recent advances in treatment have improved mortality associated with GPP, but abortion remains a significant complication. Although TNF-alpha inhibitors have proven efficacy in GPP, they can also trigger the disease. Mixed-type GPP is more similar to acute GPP than annular GPP with systemic manifestations and course.
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    Clinical Features and Natural Course of Hidradenitis Suppurativa in Turkey: A Multicenter Study
    Alpsoy, E; Karaman, BF; Demirseren, DD; Cinar, SL; Kacar, N; Ermertcan, AT; Baskan, EB; Ucmak, D; Mammadli, K; Kilinc, F; Yazici, S; Temiz, SA; Akbulut, TO; Ataseven, A; Aktürk, AS; Saricaoglu, H; Türkmen, M; Gülbasaran, F; Engin, B; Özden, HK; Durmaz, K; Özden, MG; Özdemir, H; Cemil, BÇ; Solak, SS; Bilgili, SG; Yavuz, IH; Yavuz, GÖ; Güven, M; Ekinci, AP; Atci, T; Balci, DD; Oztürk, A; Altunay, IK; Özkur, E; Ugurer, E; Karadag, AS; Kalkan, G; Kilic, S; Erdogan, B; Yayli, S; Selcuk, LB; Dönmez, L; Bilgic, A
    Introduction:The natural history, the progression of a diseaseprocess in an individual over time, has not yet been fully elu-cidated in hidradenitis suppurativa (HS). In this large multicenterstudy, we aimed to investigate the natural history of HS and itsgender differences.Methods:This cross-sectional study in-cluded 827 patients. The chronological order of the clinicalmanifestations for each patientwas recorded retrospectively.Sociodemographic characteristics, triggering factors, clinical,treatment, and prognostic features were also evaluated.Results:The mean age of disease onset was significantly younger inwomen than in men (22.42 +/- 9.28 vs. 27.06 +/- 20.56,p<0.001)and those with a family history (p<0.0001). The mean diseaseduration was 91.17 +/- 83.64 months. The most commonsymptom was purulent discharge (81%). The mean duration ofabscess was shorter in women than in men (3.11 +/- 2.65 vs.3.75 +/- 3.75,p= 0.01). The axilla was the most common onsetarea followed by the inguinal and gluteal regions. The diseaseran a more severe course in men. Abscess/inflammatory nodulewas defined in the last 6 months in 88.6% of the patients;however, thefirst 5 years of the disease were the most activedisease period in 67.5% of the patients. Multivariate analysisrevealed being male, older age, family history, involvement ofthe axillary, inguinal, and perianal regions independently as-sociated with HS severity. While antibiotic use was the mostimportant factor in improving thedisease symptoms, stress wasthe most common aggravating factor. Biological therapy in men,laser epilation and pregnancy in women were significant alle-viating factors, whereas weight gain was a more commonaggravating factor for women.Conclusion:HS shows a re-lentlessly progressive course with inflammatory attacks, but thefirst years of the disease are the most active period. This studyconfirms that environmental and hormonal factors may play animportant role in the disease course, probably with other en-dogenous or exogenous factors.(c) 2024 S. Karger AG, Basel
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    Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity
    Özkur, E; Karadag, AS; Üstüner, P; Aksoy, B; Esme, P; Çaliskan, E; Akoglu, G; Kalkan, G; Demirseren, DD; Polat, M; Ozden, MG; Kilinç, F; Iyidal, AY; Altunay, IK; Türkmen, M; Ugurer, E; Baysak, S; Karaman, BF; Mammadli, K; Selçuk, LB; Türkoglu, Z; Atci, T; Balci, DD; Adisen, E; Temel, B; Aktan, S; Kaçar, N; Gündüz, K; Ertmertcan, AT; Özdemir, M; Çakiter, AÜ; Çölgeçen, E; Uçmak, D; Kelekçi, H; Ataseven, A; Durmaz, K; Özden, HK; Engin, B; Yazici, S; Alpsoy, E
    Background Hidradenitis suppurativa (HS) is a chronic, relapsing and debilitating inflammatory disease associated with profound morbidity. Aim In this multicentre study, we investigated the demographic and clinical features of HS, and determined risk factors of disease severity. Methods In total, 1221 patients diagnosed with HS from 29 centres were enrolled, and the medical records of each patient were reviewed. Results The mean age of disease onset was 26.2 +/- 10.4 years, and almost 70% (n = 849) of patients were current or former smokers. Mean disease duration was 8.9 +/- 8.4 years with a delay in diagnosis of 5.8 +/- 3.91 years. Just over a fifth (21%; n = 256) of patients had a family history of HS. The axillary, genital and neck regions were more frequently affected in men than in women, and the inframammary region was more frequently affected in women than in men (P < 0.05 for all). Acne (40.8%), pilonidal sinus (23.6%) and diabetes mellitus (12.6%) were the most prevalent associated diseases. Of the various therapies used, antibiotics (76.4%) were most common followed by retinoids (41.7%), surgical interventions (32.0%) and biologic agents (15.4%). Logistic regression analysis revealed that the most important determinants of disease severity were male sex (OR = 2.21) and involvement of the genitals (OR = 3.39) and inguinal region (OR = 2.25). More severe disease was associated with comorbidity, longer disease duration, longer diagnosis delay and a higher number of smoking pack-years. Conclusions Our nationwide cohort study found demographic and clinical variation in HS, which may help broaden the understanding of HS and factors associated with disease severity.